7 Things Your Gynecologist Wants You to Know

By Marisa Cohen

From the WebMD Archives

No matter how comfortable you are with your gynecologist, you still may be unsure about some things, like which symptoms are worth mentioning, how often to make an appointment, and how to best prepare for an exam. Here are top tips from gynecologists on how to make the most of your visits and your relationship with your doctor.

Schedule a checkup once a year, even if you don’t need a Pap.

Even if the results of your last Pap test and HPV screening were all clear, you should still see your gynecologist.

“Cancer screenings like Paps and mammograms are just one component of the exam. It’s also important to have a yearly pelvic exam and breast exam, which is how we can detect things like fibroids and ovarian cysts,” says Allison Hill, MD, a gynecologist in Los Angeles.

Your doctor will also want to keep tabs on any changes in your period, whether the type of birth control you use is still the best option, and lifestyle issues like smoking and weight. So put that annual exam back on your calendar.

You don’t have to groom down there.

“So many women worry about whether they’ve waxed or shaved before they come in for an exam, but honestly, I never even notice!” Hill says.

Also, as much as you’d like to smell sweet down there for your doc, it’s a bad idea to douche before an appointment -- or ever.

“When you douche, that leaves us with very few clues about what’s going on in there,” says Constance Young, MD, assistant professor of obstetrics and gynecology at Columbia University Medical Center in New York.

Young also points out that rinsing with a douche can cause a bacterial infection, since it changes the balance of healthy germs and acid in your vagina. So don’t be afraid to keep things natural.

Pay attention to your regular discharge so you know when it changes.

One of the most common concerns gynecologists hear is, “I’m having some discharge. It that normal?” If it’s clear, doesn’t itch, and doesn’t smell bad, it’s probably fine. But the best way to know is to keep track of yours for a month, since healthy discharge will change throughout your menstrual cycle.

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If it’s different than the usual, check with your doctor, because it could be a yeast infection, a problem with too much bacteria, or an STD. “Infections usually have a strong fishy or foul smell, accompanied by itching or burning,” Young says.

Your doc will probably ask you to remember any changes in the 2 to 3 weeks before the discharge began. Did you have a new sex partner? Did you have unprotected sex? Did you start taking antibiotics, which can lead to a yeast infection? The more clues you can provide, the better she will be able to zero in on a cause and treatment.

There’s no need to have painful periods.

It’s normal to deal with some cramps and discomfort during your period. But if you don’t get relief from over-the-counter pain meds, or you hurt enough to stay home from school, work, or your favorite Friday night book group, you should bring it up with your doctor ASAP.

“There are so many options available to control bleeding and period pain, no one should have to suffer,” Hill says.

Birth control pills and intrauterine devices (IUDs) can reduce or even stop bleeding and cramps, and prescription forms of some pain relievers can help knock out the pain. You can also ask about tranexamic acid (Lysteda), a non-hormonal medication to manage heavy menstrual bleeding.

IUDs are for all ages.

Intrauterine devices such as the Kleena, Mirena, and ParaGard are so easy and effective, they’re one of the birth control methods that female gynecologists choose most often for themselves. But many women are still under the impression that you can only get one if you’re finished having babies, Hill says.

The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics now encourage long-acting birth control, including IUDs and the under-the-skin implant Nexplanon, for younger women and teenagers.

“These long-acting, reversible methods are perfect for women who are not great at remembering to take a pill every day and who don’t want a child for a few years,” Young says.

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When it comes to genitals, there’s a wide range of “normal.”

At least once a week, Hill says one of her patients asks, “Do I look weird down there?” Unless you see something new, like a mole, lump, or lesion, don’t worry about how your genitals look. “Everyone looks different,” Hill says. “The labia may be asymmetrical, and there are lots of skin folds and bumps down there. All those differences are usually perfectly normal.” But when in doubt, it never hurts to ask.

Your doctor’s office is a judgment-free zone.

No matter what your sexual history is, rest assured that your gynecologist is not sitting behind her desk making moral judgments. She simply needs to know the facts so she can figure out your risk for STDs and infections and help you choose the right birth control.

If you do feel that you’re being judged and it’s keeping you from being totally honest, look for a new doctor who will put you at ease so you can work together to keep you safe and healthy.